Corvallis, OR · On-site
$47.39 - $71.09/hr
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Corvallis, OR · On-site
$47.39 - $71.09/hr
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Health plan utilization management * Medicare and Medicaid rules and regulations and health plan benefit structure and policy. * Data analysis to include reporting results and developing improvement ...
Utilization Management Program Manager-RN Summary * Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP ...
Utilization Management Program Manager-RN Summary * Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP ...
Utilization Management Program Manager-RN Summary * Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP ...
Utilization Management Program Manager-RN Summary * Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP ...
Salem, OR · Remote
As a member of the Utilization Management (UM) team, our Associate Medical Director BH and UM Medical Directors provides leadership, and clinical oversight for behavioral health operations across all ...
Salem, OR · Remote
As a member of the Utilization Management (UM) team, our Associate Medical Director BH and UM Medical Directors provides leadership, and clinical oversight for behavioral health operations across all ...
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization ...
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization ...
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization ...
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization ...
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization ...
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization ...
Inpatient Rehab * Utilization Management Education * Successful completion of an RN program by date of hire. * High School Diploma or General Education Development (GED) required. License ...
Inpatient Rehab * Utilization Management Education * Successful completion of an RN program by date of hire. * High School Diploma or General Education Development (GED) required. License ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...
Salem, OR · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
Salem, OR · On-site
$130 - $140/hr
As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...
$38.9K - $50.2K
15% of jobs
$50.2K - $61.4K
8% of jobs
$63K is the 25th percentile. Wages below this are outliers.
$61.4K - $72.7K
15% of jobs
The median wage is $79.8K / yr.
$72.7K - $83.9K
20% of jobs
$83.9K - $95.2K
11% of jobs
$100.8K is the 75th percentile. Wages above this are outliers.
$95.2K - $106.4K
13% of jobs
$106.4K - $117.7K
5% of jobs
$117.7K - $128.9K
3% of jobs
$128.9K - $140.2K
4% of jobs
$140.2K - $151.4K
3% of jobs
$151.4K - $162.7K
3% of jobs
$38.9K
$89.3K
$162.7K
To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.
A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.
As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.
For Utilization Management jobs in Albany, OR, the most frequently searched job titles are:
The top searched job categories for Utilization Management jobs in Albany, OR are:
Cities near Albany, OR with the most Utilization Management job openings:
$47.39 - $71.09/hr
Full-time
Re-posted 18 days ago
7.5
Based on 65 frontline employees who took The Breakroom Quiz
234th of 887 rated healthcare providers
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